Extravasation Of Chemotherapeutic Agents: Failure To Properly Treat

The failure to treat a patient properly and in a timely manner can have a serious impact on that patient’s life.  Timely treatment can be delayed if the condition is not diagnosed properly and quickly.  This is essential for all serious condition including extravasation.

The extravasation of chemotherapeutic agents that have been intravenously administered into the subcutaneous tissue of cancer patients who are undergoing chemotherapy is a treatment risk that is well known.  Extravasation is the accidental administration of intravenously infused medications in to the space or tissue around the infusion sites by leakage, previous venipuncture, or direct leakage from the venous access device being mispositioned.

The severity of an injury caused by extravasation depends on the type of drug that extravasates.  The most destructive of these injures are caused by anti-tumor drugs that bind to DNA.  Chemotherapeutic agents that are extravasated bind to nucleic acids leading to prolonged course of injury.  One drug, Doxorubicin, causes severe progressive tissue necrosis involving the muscles and tendons.  There has been no antidote developed so the recommended treatment for Doxorubicin extravasation is to excise all infiltrated tissue as soon as possible.  The injection of saline solution where extravasation of a chemo-therapeutic agent is said to have had some success in reducing the concentration of the extravasated drug.  However, other believe that such an injection only serves to increase the diffusion of the extravasated agent into the surrounding tissue.

When a DNA-binding chemotherapy has been extravasated, the immediate treatment should include elevation of the extremity effected and intermittent cold.  It does not appear that there is any agent that if injected locally will alter the final result from extravasation of a binding chemotherapeutic agent.  Persistent swelling, erythema, and pain are indications that there should be a surgical consultation, even when ulcerations have not yet appeared.  Once blistering and ulcerations are seen, a surgical consultation is mandatory.

Doctors who are treating a patient with chemotherapy need to be aware of the patient and know if extravasation has occurred.  Only then can treatment of the condition begin.  If you or a loved one has been injured due to extravasation contact an experienced Kingston, New York medical malpractice attorney as soon as possible to evaluate your case.

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